Clinic Theory Ii Dental Implants

Front 1

For Pt's with implants, how often should they have RADS?

Back 1

Every Year.
Bone height can change drastically and in a short period of time.

Front 2

What is a dental implant?

Back 2

A non-biologic (man-made) tooth root.
It provides a missing tooth and/or provides support for a prosthetic denture.

Front 3

When was the 1st successful implant supported prosthetic utilized in the edentulous jaw?

Back 3

1965

Front 4

What 3 things make up "Implant Anatomy"?

Back 4

1) Implant fixture 2) Abutment 3) Prosthetic Crown

Front 5

What are the supporting structures of an implant? (4)

Back 5

1) Sulcus
2) JE
3) Connective Tissue
4) Bone

*Ideally you want keratinized tissue around the implant at the perimucosal site.*

Front 6

After placing the implant, how long do you need to wait before "loading" it?

Back 6

About 2-6 months. It depends on site, bone & load weight.

Front 7

What is Osseo-integration or (bone wounding)

Back 7

Its an inflammatory reaction, bone resorption and then bone formation around an implant.

Front 8

A lack of PDL makes ____________ very important due to a lack of sensitivity.

Back 8

Occlusion

Front 9

Immediately loaded implants can be ____________.

Back 9

Unpredictable

**You must have available bone so it has to be a healthy site, no abscess. They must be loaded in the first 2 weeks when the bone is most stable & hasn't started to break down.**

Front 10

What is the usual time period to load an implant if its being placed after the bone is healed?

Back 10

3-6 months after implant placement.

Front 11

What are 3 types of implants?

Back 11

1) Trans-osteal --> through the bone
2) Endosseous --> In Bone
3) Sub- Periosteal --> under the periosteum.

(Periosteum is the membrane that wraps or lines the surface of all bones.)

Front 12

Describe a transosteal implant.

Back 12

A metal plate, fitted into the inferior boarderof the mandles that has pins extending toward the occlusal surface.
Two pins protrude into the oral cavity to support an over denture or bridge.

Front 13

What is an endosseous implant like?

Back 13

Implants placed into the edentulous area of the Mx of Mn. They can be cylindrical (root form) or flat (blade like) in shape.

Front 14

Describe a subperiosteal implant.

Back 14

The implant is under the periosteum or "on bone".
It’s a lattice-like metal plate, custom fabricated & rests directly on a severly resorbed ridge.
The posts protrude through the mucosa into the mouth.

Front 15

Are there any ligaments involved in the anchorage of an implant?

Back 15

No!
The implant can be compared to the root of the tooth. It is supported by bone.

*The implant does effect how deposits are removed.*

Front 16

What is the ONLY reason to probe an implant?

Back 16

The ONLY reason to probe an implant is when it is failing and you're checking bone levels.

Front 17

What are a few things to check when you're assessing an implant?

Back 17

Tissue consistency (form & color),
Inflammation,
Bleeding or Exudate,
Occlusion,
PT hygiene adequacy.

Front 18

What is mobility of an implant indicative of?

Back 18

Failure. Implants should never be mobile.

Front 19

Do implants have a PDL?

Back 19

NO!

Front 20

When checking bone levels for implants, to what degree of loss is acceptible in the first year?

Back 20

Bone loss to the first thread of an implant is acceptable in the first year.

**Increments > .5mm per year indicates possible failure.**

Front 21

Describe the bone loss pattern in implants.

Back 21

Tend to be circumfrential moat-like morphology.

Front 22

What are most implants made of?

Back 22

Titanium

Front 23

What type of instruments should be used for the debridement of implants?

Back 23

Only use instruments that are softer than titanium. (Plastic, Teflon coated, nylon or graphite are recommended.)

Front 24

What type of ultra sonic scalers can be used with implants?

Back 24

Those with non-metal tips or plastic sleeves are best.

Front 25

What type of calc is less common around implants than around natural teeth>

Back 25

Sub-G calc is less common.

*Most instrumentation will be supra-gingival, above the titanium implant.

Front 26

What types of strokes should you use around an implant?

Back 26

Short, controlled with light pressure.

Front 27

Why are sickle and universal curet shaped working ends the most commonly used for implants?

Back 27

They adapt well & the stroke pattern can be oblique, horizontal or vertical.

Front 28

Why should you keep the home care routine simple for implants?

Back 28

You'll have greater compliance.

*Products are safe for implants--> they won't scratch. Implant floss is yarn like.*

Front 29

How do I as a DH handle the maintenace of prosthetics?

Back 29

The same way as a conventional denture.
Brush with a stiff brush
Soak in ultrasonic solution
Check attachments for integrity.

Front 30

What are the 2 types of Implant Disease?

Back 30

1) Peri-Implant Mucositis (Implant gingivitis)
2) Peri-Implantitis (Implant periodontitis)

Front 31

What actually is Peri-Implant Mucositis?

Back 31

An inflammatory lesion (gingivitis) that resides in the peri-implant mucosa.
It can be chronic or acute and with or without pain.
If left untreated it leads to implantitis.

Front 32

What actually is Peri-implantitis?

Back 32

An inflammatory lesion characterized by changes at the level of the crestal bone in conjunction with BOP with or without concomitant deepening of the peri-implant pocket.

Front 33

In peri-implantitis is the sub-G microbiota more or less complex?

Back 33

Its more complex.
It may explain why the clinical Mgmt of these lesions is so challenging.

Front 34

What is the Number 1 reason for implant failure?

Back 34

Cement being retained at the margins! (81% of all cases)

Front 35

Other than cement being retained at the margins, what are a few other reasons for implants to fail?

Back 35

Sometimes they fail for no reason at all
Poor OHI
PT may have compromised health
Smoking or Diabetes